• Posted December 16, 2025

Childhood Behavioral Problems Are Straining Family Finances, Experts Say

Kids’ behavioral problems account for a growing chunk of their health care costs, a new study says.

Mental health, substance use and other behavioral health care made up about 40% of all health expenditures for U.S. children in 2022, nearly twice as much as in 2011, according to findings published Dec. 15 in JAMA Pediatrics.

In fact, costs to families for this type of care grew more than twice as fast as the costs of other medical care, researchers found.

Out-of-pocket spending on behavioral health rose an average 6.4% annually for families, compared with 2.7% for other health care, the study showed.

“Families are bearing growing costs,” lead researcher Dr. Ashley Foster, a pediatric emergency care physician at UCSF Benioff Children’s Hospitals, said in a news release.

“As a country, we need to make sure behavioral health care is accessible and affordable for every family, regardless of insurance status,” she said.

For the study, researchers analyzed 11 years of national spending data on children between the ages of 6 and 17, running from 2011 through 2022.

By 2022, behavioral health accounted for $41.8 billion of overall health spending, and families were paying $2.9 billion on it — more than a quarter of their out-of-pocket health spending, researchers said.

Kids who need behavioral health care increase a family’s risk of financial hardship, researchers said.

“Families with at least one child who has behavioral health issues are 60% more likely to face a high financial burden, and 40% more likely to have an extreme financial burden — meaning more than 10% of their family income goes toward that care,” Foster said.

The study wasn’t designed to say why this is, but researchers found a few clues in the data.

“It’s likely a combination of a few factors: more children having behavioral health challenges, in part due to the COVID-19 pandemic; a rise in costs per visit over time; and an increase in access to care,” Foster said. “Access has improved thanks to less stigma about mental health challenges and because there are more community-based care venues now.”

Results also showed some shifts in how kids are receiving behavioral health care.

Spending increased 25% per year for home health services, compared to 11% a year for in-person counseling. The number of telehealth visits increased 99% per year between 2020 and 2022.

“Telehealth is here to stay,” Foster said.

More information

Children’s Hospital Colorado has more on behavioral issues in children.

SOURCE: University of California - San Francisco, news release, Dec. 15, 2025